Effect of Replacing Added Sugars with Sucralose on Gut Microbiome Composition Among Asian Indian Adults in Two 12-week Randomized Controlled Trials.

抄録

Background: Replacing added sugars with nonnutritive sweeteners, such as sucralose, may help reduce weight gain in adults over time. Because sucralose is primarily excreted in the stool, its consumption could lead to changes in the gut microbiome.Objectives: We aimed to explore whether replacing sucrose used in beverages with small quantities of sucralose led to gut microbiome changes among Asian Indian adults with type 2 diabetes (T2D) or overweight/obesity (BMI ≥23 kg/m²) without T2D.Methods: In 2 analogous substudies nested within two 12-wk, open-label parallel-arm randomized controlled trials, adults with T2D (n = 49) or overweight/obesity and no T2D (n = 48) were instructed to replace sucrose in their daily coffee and tea with sucralose or to continue their use of sucrose. We examined changes in gut microbiome community structure and taxonomic composition profiled using 16S rRNA sequencing in stool samples collected before and after the 12-wk interventions. The false discovery rate was controlled using the Benjamini-Hochberg method (q < 0.20).Results: Compared with the control group, the sucralose intervention decreased α diversity (Shannon index: P = 0.02; Simpson index: P = 0.03) and increased β diversity (P = 0.001) in gut microbiome communities of adults with T2D, but not among adults with overweight/obesity (all between-group P > 0.05). Among 185 genera tested in the T2D trial, compared with the control, relative abundances of 14 primarily sugar-fermenting or short-chain fatty-acid-producing Firmicutes bacteria in the Lachnospiracae family were reduced, whereas Enterococcus and Pediococcus increased during the intervention (q < 0.20). In contrast, adults with overweight/obesity and no T2D showed no similar changes.Conclusions: Replacing daily sucrose added to coffee and tea with sucralose resulted in changes in gut microbiome community structure and taxonomic composition among Asian Indian adults with T2D, but not those with overweight/obesity and no T2D. Further studies are needed to understand potential health implications and the underlying drivers of these gut microbiome changes.Clinical Trial Register No. (India Trial Register): CTRI/2021/04/032686, CTRI/2021/04/032809.